The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

The Ultimate Secrecy: Feminist Readings of Masculine Trauma in Vietnam War Literature

It is a widely acknowledged and often unquestioned fact that patriarchy and its modes of behaviour and social organization favour the appearance of trauma on the weakest (and defenceless) members of society: women. In the last decades, trauma seems to have taken the baton of typically female maladies such as 19th c. hysteria or 20th c. madness. Feminists in the 20th c. have long worked to prove the connection between the latter affections (and their reflection in literary texts) and patriarchal oppression or expectations of feminine behaviour and accordance to roles and rules. With Trauma Studies on the rise, the approach to the idea of the untold as related to femininity is manifold: on the one hand, is not trauma, which precludes telling about one’s own experience and keeps it locked not only from the others, but also from ourselves, the ultimate secrecy? On the other hand, when analyzing works that reflect trauma, one is astounded by the high number of them with a female protagonist and an almost all-female cast: in this sense, a ‘feminist’ reading is almost compulsory, in the sense that it is usually the author’s assumption that patriarchal systems of exploitation and expectations favour traumatic events and their outcome (silence and secrets) on the powerless, usually women. Often, traumatic texts combine feminism with other analytical discourses (one of the topics proposed for this panel): Toni Morrison’s study of traumatic responses in The Bluest Eye and Beloved cannot be untangled from her critique of slavery; just as much of Chicana feminism and its representations of rape and abuse (two main agents of trauma) analyze the nexus of patriarchy, new forms of post-colonialism, and the dynamics of power and powerlessness in ethnic contexts. Within this tradition that establishes the secrecies of trauma as an almost exclusively feminine characteristic, one is however faced with texts which have traumatized males as protagonists: curiously enough, most of these characters have suffered trauma through a typically masculine experience: that of war and its aftermath. By analyzing novels dealing with war veterans from Vietnam or the Second World War, the astounding findings are the frequent mixture of masculine or even ‘macho’ values and the denial of any kind of ‘feminine’ characteristics, combined with a very strict set of rules of power and hierarchy that clearly establish who is empowered and who is powerless. It is our argument that this replication of patriarchal modes of domination, which place the lowest ranks of the army in a ‘feminine’ situation, blended with the compulsory ‘macho’ stance soldiers are forced to adopt as army men (as seen, for example, in Philip Caputo’s Indian Country, Larry Heinemann’s Paco’s Story or Ed Dodge’s DAU: A Novel of Vietnam) furthers the onset and seriousness of ulterior trauma. In this sense, we can also analyze this kind of writing from a ‘feminist’ point of view, since the dynamics of über-patriarchal power established at the front at war-time deny any display of elements traditionally viewed as ‘feminine’ (such as grief, guilt or emotions) in soldiers. If trauma is the result of a game of patriarchal empowerment, how can feminist works, not only theoretical, but also fictional, overthrow it? Are ‘feminine’ characteristics necessary to escape trauma, even in male victims? How can feminist readings of trauma enhance our understanding of its dynamics and help produce new modes of interaction that transcend power and gender division as the basis for the organization of society?

Optical sensing of the fatigue damage state of CFRP under realistic aeronautical load sequences

Abstract: We present an optical sensing methodology to estimate the fatigue damage stateof structures made of carbon fiber reinforced polymer (CFRP), by measuring variations on the surface roughness. Variable amplitude loads (VAL), which represent realistic loads during aeronautical missions of fighter aircraft (FALSTAFF) have been applied to coupons until failure. Stiffness degradation and surface roughness variations have been measured during the life of the coupons obtaining a Pearson correlation of 0.75 between both variables. The data were compared with a previous study for Constant Amplitude Load (CAL) obtaining similar results. Conclusions suggest that the surface roughness measured in strategic zones is a useful technique for structural health monitoring of CFRP structures, and that it is independent of the type of load applied. Surface roughness can be measured in the field by optical techniques such as speckle, confocal perfilometers and interferometry, among others.

Eulerian-Lagrangian definition of coarse bed-load transport: Theory and verification with low-cost inertial measurement units

Fluvial sediment transport is controlled by hydraulics, sediment properties and arrangement, and flow history across a range of time scales. This physical complexity has led to ambiguous definition of the reference frame (Lagrangian or Eulerian) in which sediment transport is analysed. A general Eulerian-Lagrangian approach accounts for inertial characteristics of particles in a Lagrangian (particle fixed) frame, and for the hydrodynamics in an independent Eulerian frame. The necessary Eulerian-Lagrangian transformations are simplified under the assumption of an ideal Inertial Measurement Unit (IMU), rigidly attached at the centre of the mass of a sediment particle. Real, commercially available IMU sensors can provide high frequency data on accelerations and angular velocities (hence forces and energy) experienced by grains during entrainment and motion, if adequately customized. IMUs are subjected to significant error accu- mulation but they can be used for statistical parametrisation of an Eulerian-Lagrangian model, for coarse sediment particles and over the temporal scale of individual entrainment events. In this thesis an Eulerian-Lagrangian model is introduced and evaluated experimentally. Absolute inertial accelerations were recorded at a 4 Hz frequency from a spherical instrumented particle (111 mm diameter and 2383 kg/m3 density) in a series of entrainment threshold experiments on a fixed idealised bed. The grain-top inertial acceleration entrainment threshold was approximated at 44 and 51 mg for slopes 0.026 and 0.037 respectively. The saddle inertial acceleration entrainment threshold was at 32 and 25 mg for slopes 0.044 and 0.057 respectively. For the evaluation of the complete Eulerian-Lagrangian model two prototype sensors are presented: an idealised (spherical) with a diameter of 90 mm and an ellipsoidal with axes 100, 70 and 30 mm. Both are instrumented with a complete IMU, capable of sampling 3D inertial accelerations and 3D angular velocities at 50 Hz. After signal analysis, the results can be used to parametrize sediment movement but they do not contain positional information. The two sensors (spherical and ellipsoidal) were tested in a series of entrainment experiments, similar to the evaluation of the 111 mm prototype, for a slope of 0.02. The spherical sensor entrained at discharges of 24.8 ± 1.8 l/s while the same threshold for the ellipsoidal sensor was 45.2 ± 2.2 l/s. Kinetic energy calculations were used to quantify the particle-bed energy exchange under fluvial (discharge at 30 l/s) and non-fluvial conditions. All the experiments suggest that the effect of the inertial characteristics of coarse sediments on their motion is comparable to the effect hydrodynamic forces. The coupling of IMU sensors with advanced telemetric systems can lead to the tracking of Lagrangian particle trajectories, at a frequency and accuracy that will permit the testing of diffusion/dispersion models across the range of particle diameters.

Assessments of training load in elite youth soccer

One of the most popular sports globally, soccer has seen a rise in the demands of the game over recent years. An increase in intensity and playing demands, coupled with growing social and economic pressures on soccer players means that optimal preparation is of paramount importance. Recent research has found the modern game, depending on positional role, to consist of approximately 60% more sprint distance in the English Premier League, which was also found to be the case for frequency and success of discrete technical actions (Bush et al., 2015). As a result, the focus on soccer training and player preparedness is becoming more prevalent in scientific research. By designing the appropriate training load, and thus periodization strategies, the aim is to achieve peak fitness in the most efficient way, whilst minimising the risk of injury and illness. Traditionally, training intensity has been based on heart rate responses, however, the emergence of tracking microtechnology such as global positioning system (GPS) and inertial sensors are now able to further quantify biomechanical load as well as physiological stress. Detailed pictures of internal and external loading indices such as these then combine to produce a more holistic view of training load experience by the player during typical drills and phases of training in soccer. The premise of this research is to gain greater understanding of the physical demands of common training methodologies in elite soccer to support optimal match performance. The coaching process may then benefit from being able to prescribe the most effective training to support these. The first experimental chapter in this thesis began by quantify gross training loads of the pre-season and in-season phases in soccer. A broader picture of the training loads inherent in these distinct phases brought more detail as to the type and extent of external loading experienced by soccer players at these times, and how the inclusion of match play influences weekly training rhythms. Training volume (total distance) was found to be high at the start compared to the end of pre-season (37 kilometres and 28 kilometres), where high cardiovascular loads were attained as part of the conditioning focus. This progressed transiently, however, to involve higher-speed, acceleration and change-of-direction stimuli at the end of pre-season compared to the start and to that in-season (1.18 kilometres, 0.70 kilometres and 0.42 kilometres high-intensity running; with 37, 25 and 23 accelerations >3m/s2 respectively) . The decrease in volume and increase in maximal anaerobic activity was evident in the training focus as friendly matches were introduced before the competitive season. The influence of match-play as being a large physical dose in the training week may then determine the change in weekly periodisation and how resulting training loads applied and tapered, if necessary. The focus of research was then directed more specifically to the most common mode of training in soccer, that also featured regularly in the pre-season period in the present study, small-sided games (SSG). The subsequent studies examined numerous manipulations of this specific form of soccer conditioning, such as player numbers as well as absolute and relative playing space available. In contrast to some previous literature, changing the number of players did not seem to influence training responses significantly, although playing format in the possession style brought about larger effects for heart rate (89.9%HRmax) and average velocity (7.6km/h-1). However, the following studies (Chapters 5, 6 and 7) revealed a greater influence of relative playing space available to players in SSG. The larger area at their disposal brought about greater aerobic responses (~90%HRmax), by allowing higher average and peak velocities (>25km/h-1), as well as greater distance acceleration behaviour at greater thresholds (>2.8m/s2). Furthermore, the data points towards space as being a large determinant in strategy of the player in small-sided games (SSG), subsequently shaping their movement behaviour and resulting physical responses. For example, higher average velocities in a possession format (8km/h-1) reflects higher work rate and heart rate load but makes achieving significant neuromuscular accelerations at a high level difficult given higher starting velocities prior to the most intense accelerations (4.2km/h-1). By altering space available and even through intentional numerical imbalances in team numbers, it may be easier for coaches to achieve the desired stimulus for the session or individual player, whether that is for aerobic and neuromuscular conditioning. Large effects were found for heart rate being higher in the underloaded team (85-90%HRmax) compared to the team with more players (80-85%HRmax) as well as for RPE (5AU versus 7AU). This was also apparent for meterage and therefore average velocity. It would also seem neuromuscular load through high acceleration and deceleration efforts were more pronounced with less numbers (given the need to press and close down opponents, and in a larger area relative to the number of players on the underloaded team. The peak accelerations and deceleration achieved was also higher when playing with less players (3-6.2m/s2 and 3-6.1m/s2) Having detailed ways in which to reach desired physical loading responses in common small training formats, Chapter 8 compared SSG to larger 9v9 formats with full-size 11v11 friendly matches. This enabled absolute and relative comparisons to be made and to understand the extent to which smaller training formats are able to replicate the required movements to be successful in competition. In relative terms, it was revealed that relative acceleration distance and Player Load were higher in smaller 4v4 games than match-play (1.1m.min-1 and 0.3m.min-1 >3m/s2; 16.9AU versus 12AU). Although the smallest format did not replicate the high-velocity demands of matches, the results confirmed their efficacy in providing significant neuromuscular load during the training week, which may then be supplemented by high-intensity interval running in order to gain exposure to more maximal speed work. In summary, the data presented provide valuable information from GPS and inertial sensor microtechnology which may then be used to understand training better to manipulate types of load according to physical conditioning objectives. For example, a library of resources to direct planning of drills of varying cardiovascular, neuromuscular and perceptual load can be created to give more confidence in session outcomes. Combining external and internal load data of common soccer training drills, and their application across different phases and training objectives may give coaches a powerful tool to plan and periodize training.

Load Profile Analysis Tool for Electrical Appliances in Households

This paper presents a methodology to forecast the hourly and daily consumption in households. The methodology was validated for households in Lisbon region, Portugal. The paper shows that the forecast tool allows obtaining satisfactory results for forecasting. Models of demand response allow the support of consumer’s decision in exchange for an economic benefit by the redefinition of load profile or changing the appliance consumption period. It is also in the interest of electric utilities to take advantage of these changes, particularly when consumers have an action on the demand-side management or production. Producers need to understand the load profile of households that are connected to a smart grid, to promote a better use of energy, as well as optimize the use of micro-generation from renewable sources, not only to delivering to the network but also in self-consumption.

Load Profile Analysis Tool for Electrical Appliances in Households Assisted by CPS

This paper presents a methodology to forecast the hourly and daily consumption in households assisted by cyber physical systems. The methodology was validated using a database of consumption of a set of 93 domestic consumers. Forecast tools used were based on Fast Fourier Series and Generalized Reduced Gradient. Both tools were tested and their forecast results were compared. The paper shows that both tools allow obtaining satisfactory results for energy consumption forecasting.

GA-ANN Short-Term Electricity Load Forecasting

This paper presents a methodology for short-term load forecasting based on genetic algorithm feature selection and artificial neural network modeling. A feed forward artificial neural network is used to model the 24-h ahead load based on past consumption, weather and stock index data. A genetic algorithm is used in order to find the best subset of variables for modeling. Three data sets of different geographical locations, encompassing areas of different dimensions with distinct load profiles are used in order to evaluate the methodology. The developed approach was found to generate models achieving a minimum mean average percentage error under 2 %. The feature selection algorithm was able to significantly reduce the number of used features and increase the accuracy of the models.

Load balancing for constraint solving with GPUs

Solving a complex Constraint Satisfaction Problem (CSP) is a computationally hard task which may require a considerable amount of time. Parallelism has been applied successfully to the job and there are already many applications capable of harnessing the parallel power of modern CPUs to speed up the solving process. Current Graphics Processing Units (GPUs), containing from a few hundred to a few thousand cores, possess a level of parallelism that surpasses that of CPUs and there are much less applications capable of solving CSPs on GPUs, leaving space for further improvement. This paper describes work in progress in the solving of CSPs on GPUs, CPUs and other devices, such as Intel Many Integrated Cores (MICs), in parallel. It presents the gains obtained when applying more devices to solve some problems and the main challenges that must be faced when using devices with as different architectures as CPUs and GPUs, with a greater focus on how to effectively achieve good load balancing between such heterogeneous devices.

Distraction by task-irrelevant stimuli: the effects of endogenous spatial attention and visual working memory load

Salient stimuli, like sudden changes in the environment or emotional stimuli, generate a priority signal that captures attention even if they are task-irrelevant. However, to achieve goal-driven behavior, we need to ignore them and to avoid being distracted. It is generally agreed that top-down factors can help us to filter out distractors. A fundamental question is how and at which stage of processing the rejection of distractors is achieved. Two circumstances under which the allocation of attention to distractors is supposed to be prevented are represented by the case in which distractors occur at an unattended location (as determined by the deployment of endogenous spatial attention) and when the amount of visual working memory resources is reduced by an ongoing task. The present thesis is focused on the impact of these factors on three sources of distraction, namely auditory and visual onsets (Experiments 1 and 2, respectively) and pleasant scenes (Experiment 3). In the first two studies we recorded neural correlates of distractor processing (i.e., Event-Related Potentials), whereas in the last study we used interference effects on behavior (i.e., a slowing down of response times on a simultaneous task) to index distraction. Endogenous spatial attention reduced distraction by auditory stimuli and eliminated distraction by visual onsets. Differently, visual working memory load only affected the processing of visual onsets. Emotional interference persisted even when scenes occurred always at unattended locations and when visual working memory was loaded. Altogether, these findings indicate that the ability to detect the location of salient task-irrelevant sounds and identify the affective significance of natural scenes is preserved even when the amount of visual working memory resources is reduced by an ongoing task and when endogenous attention is elsewhere directed. However, these results also indicate that the processing of auditory and visual distractors is not entirely automatic.

Numerical and physical modelling of axially loaded piles for offshore wind turbines

The scope of the thesis is to broaden the knowledge about axially loaded pipe piles, that can play as foundations for offshore wind turbines based on jacket structures. The goal of the work was pursued by interpreting experimental data on large-scale model piles and by developing numerical tools for the prediction of their monotonic response to tensile and compressive loads to failure. The availability of experimental results on large scale model piles produced in two different campaigns at Fraunhofer IWES (Hannover, Germany) represented the reference for the whole work. Data from CPTs, blow counts during installation and load-displacement curves allowed to develop considerations on the experimental results and comparison with empirical methods from literature, such as CPT-based methods and Load Transfer methods. The understanding of soil-structure interaction mechanisms has been involved in the study in order to better assess the mechanical response of the sand with the scope to help in developing predictive tools of the experiments. A lack of information on the response of Rohsand 3152 when in contact with steel was highlighted, so the necessity of better assessing its response was fulfilled with a comprehensive campaign of interface shear test. It was found how the response of the sand to ultimate conditions evolve with the roughness of the steel, which is a precious information to take account of when attempting the prediction of a pile capacity. Parallel to this topic, the work has developed a numerical modelling procedure that was validated on the available large-scale model piles at IWES. The modelling strategy is intended to build a FE model whose mechanical properties of the sand come from an interpretation of commonly available geotechnical tests. The results of the FE model were compared with other predictive tools currently used in the engineering practice.

"Tecniche di Load Pull attivo a bassa frequenza per la caratterizzazione in banda base di transistori per applicazioni RF"

Una sempre crescente quantità di informazione digitale viene condivisa tra miliardi di dispositivi connessi in ogni angolo del pianeta. Per riuscire a sfruttare una banda più ampia ed aumentare la velocità di trasmissione dei dati, i prossimi standard di telecomunicazioni wireless dovranno adoperare frequenze operative sempre più alte, cercando di rispettare stringenti specifiche in termini di affidabilità ed efficienza energetica. In generale, le prestazioni di un transistor dipenderanno dalle terminazioni a cui esso è collegato. In un setup di caratterizzazione e test, è possibile, tramite un metodo noto come load pull attivo, sintetizzare un determinato valore di impedenza ad uno o più piani di riferimento all'interno di un circuito. Questa strategia si basa in generale sulla manipolazione del rapporto tra onde entranti ed uscenti da un piano di riferimento del dispositivo. Se da una parte tecniche di load pull attivo a banda larga a radiofrequenza hanno ricevuto un notevole interesse sia commerciale che accademico, dall'altra le strategie per la sintesi di impedenze presenti al terminale di alimentazione dell'amplificatore, sono state meno investigate. Questo elaborato si propone di introdurre un algoritmo per il load pull attivo a banda base per amplificatori per applicazioni RF. Dopo un'introduzione sui modelli comportamentali degli amplificatori, è stato considerato il problema degli effetti di memoria. È stata poi descritta la tecnica per l'emulazione di impedenze. Dapprima, è stato considerato il caso lineare. Poi, tramite il design di un amplificatore di potenza per applicazioni a radio frequenza usato come device under test (DUT), sono stati affrontati due esempi in presenza di non linearità, verificando la correttezza della tecnica proposta tramite l'uso di simulazioni.

The Clinical Impact Of Cerebellar Grey Matter Pathology In Multiple Sclerosis.

The cerebellum is an important site for cortical demyelination in multiple sclerosis, but the functional significance of this finding is not fully understood. To evaluate the clinical and cognitive impact of cerebellar grey-matter pathology in multiple sclerosis patients. Forty-two relapsing-remitting multiple sclerosis patients and 30 controls underwent clinical assessment including the Multiple Sclerosis Functional Composite, Expanded Disability Status Scale (EDSS) and cerebellar functional system (FS) score, and cognitive evaluation, including the Paced Auditory Serial Addition Test (PASAT) and the Symbol-Digit Modalities Test (SDMT). Magnetic resonance imaging was performed with a 3T scanner and variables of interest were: brain white-matter and cortical lesion load, cerebellar intracortical and leukocortical lesion volumes, and brain cortical and cerebellar white-matter and grey-matter volumes. After multivariate analysis high burden of cerebellar intracortical lesions was the only predictor for the EDSS (p<0.001), cerebellar FS (p = 0.002), arm function (p = 0.049), and for leg function (p<0.001). Patients with high burden of cerebellar leukocortical lesions had lower PASAT scores (p = 0.013), while patients with greater volumes of cerebellar intracortical lesions had worse SDMT scores (p = 0.015). Cerebellar grey-matter pathology is widely present and contributes to clinical dysfunction in relapsing-remitting multiple sclerosis patients, independently of brain grey-matter damage.

Effect Of Simulated Microwave Disinfection On The Linear Dimensional Change, Hardness And Impact Strength Of Acrylic Resins Processed By Different Polymerizing Cycles.

This study investigated the effect of simulated microwave disinfection (SMD) on the linear dimensional changes, hardness and impact strength of acrylic resins under different polymerization cycles. Metal dies with referential points were embedded in flasks with dental stone. Samples of Classico and Vipi acrylic resins were made following the manufacturers' recommendations. The assessed polymerization cycles were: A-- water bath at 74ºC for 9 h; B-- water bath at 74ºC for 8 h and temperature increased to 100ºC for 1 h; C-- water bath at 74ºC for 2 h and temperature increased to 100ºC for 1 h;; and D-- water bath at 120ºC and pressure of 60 pounds. Linear dimensional distances in length and width were measured after SMD and water storage at 37ºC for 7 and 30 days using an optical microscope. SMD was carried out with the samples immersed in 150 mL of water in an oven (650 W for 3 min). A load of 25 gf for 10 sec was used in the hardness test. Charpy impact test was performed with 40 kpcm. Data were submitted to ANOVA and Tukey's test (5%). The Classico resin was dimensionally steady in length in the A and D cycles for all periods, while the Vipi resin was steady in the A, B and C cycles for all periods. The Classico resin was dimensionally steady in width in the C and D cycles for all periods, and the Vipi resin was steady in all cycles and periods. The hardness values for Classico resin were steady in all cycles and periods, while the Vipi resin was steady only in the C cycle for all periods. Impact strength values for Classico resin were steady in the A, C and D cycles for all periods, while Vipi resin was steady in all cycles and periods. SMD promoted different effects on the linear dimensional changes, hardness and impact strength of acrylic resins submitted to different polymerization cycles when after SMD and water storage were considered.

Association Between Prehypertension, Metabolic And Inflammatory Markers, Decreased Adiponectin And Enhanced Insulinemia In Obese Subjects.

Obesity is associated with development of the cardiorenal metabolic syndrome, which is a constellation of risk factors, such as insulin resistance, inflammatory response, dyslipidemia, and high blood pressure that predispose affected individuals to well-characterized medical conditions such as diabetes, cardiovascular and kidney chronic disease. The study was designed to establish relationship between metabolic and inflammatory disorder, renal sodium retention and enhanced blood pressure in a group of obese subjects compared with age-matched, lean volunteers. The study was performed after 14 h overnight fast after and before OGTT in 13 lean (BMI 22.92 ± 2.03 kg/m(2)) and, 27 obese (BMI 36.15 ± 3.84 kg/m(2)) volunteers. Assessment of HOMA-IR and QUICKI index were calculated and circulating concentrations of TNF-α, IL-6 and C-reactive protein, measured by immunoassay. THE STUDY SHOWS THAT A HYPERINSULINEMIC (HI: 10.85 ± 4.09 μg/ml) subgroup of well-characterized metabolic syndrome bearers-obese subjects show higher glycemic and elevated blood pressure levels when compared to lean and normoinsulinemic (NI: 5.51 ± 1.18 μg/ml, P < 0.027) subjects. Here, the combination of hyperinsulinemia, higher HOMA-IR (HI: 2.19 ± 0.70 (n = 12) vs. LS: 0.83 ± 0.23 (n = 12) and NI: 0.98 ± 0.22 (n = 15), P < 0.0001) associated with lower QUICKI in HI obese when compared with LS and NI volunteers (P < 0.0001), suggests the occurrence of insulin resistance and a defect in insulin-stimulated peripheral action. Otherwise, the adiponectin measured in basal period was significantly enhanced in NI subjects when compared to HI groups (P < 0.04). The report also showed a similar insulin-mediated reduction of post-proximal urinary sodium excretion in lean (LS: 9.41 ± 0.68% vs. 6.38 ± 0.92%, P = 0.086), and normoinsulinemic (NI: 8.41 ± 0.72% vs. 5.66 ± 0.53%, P = 0.0025) and hyperinsulinemic obese subjects (HI: 8.82 ± 0.98% vs. 6.32 ± 0.67%, P = 0.0264), after oral glucose load, despite elevated insulinemic levels in hyperinsulinemic obeses. In conclusion, this study highlights the importance of adiponectin levels and dysfunctional inflammatory modulation associated with hyperinsulinemia and peripheral insulin resistance, high blood pressure, and renal dysfunction in a particular subgroup of obeses.